Unlocking the potential of 3D printing in radiology

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 - 3D Heart Model
Source: Mayo Clinic

A 3D printing lab in the radiology department can bring a wide range of benefits, including improved surgical preparation, trainee education and inter-departmental collaboration. While it requires a significant financial investment, Mayo Clinic Radiology Chair Kent R. Thielen, MD, believes that the perks far outweigh the price tag. Thielen will be discussing the added value of 3D printing on Monday, Nov. 28, at RSNA 2016.

“By delivering high-quality services and trying to exceed expectations, institutional leadership is very happy to have this printing lab in radiology,” he said.

The seed for a printing lab integrated into the radiology department was planted in 2006, when interventional radiologists faced a challenging case of conjoined twins. Linked in the chest area, efforts to separate the two girls stagnated until two radiologists conjured up an unorthodox idea.

“There was a relatively crude 3D printer in our engineering lab, and we just happened to have two radiologists with past experience in 3D printing,” said Thielen. “We put together a model and the pediatric surgeon was able to separate the twins—who are now thriving 10-year-old girls. You would never know they were connected.”

This experience shined a light on how 3D models can aid preoperative planning, and Mayo began using the printer more regularly. However, the model volume remained low, and the technology was only used for unique cases. It wasn’t until 2013, when the idea of a dedicated 3D printing lab located in radiology was revisited, that demand for the models grew.

“We opened the lab in July 2013 and had an explosion in the demand for the models—and it’s grown exponentially every year,” said Thielen. “We had been doing 20 models a year, and in the first six months with the dedicated lab, we made 50.”

Cut to the present, where the lab has grown yet again. It now features three printers, full-time biomedical engineers and site radiologists whose sole responsibility is ensuring smooth operation of the lab.

“[The radiologists] facilitate clinical consults and help with complex segmenting that our CT technologists can’t complete—it’s really taken off,” said Thielen.

The primary clinical use for the 3D models is preparing doctors for complex interventions, both surgical and image-guided. For example, surgeons practice deploying aortic grafts on unbelievably detailed hearts, complete with simulated blood pumping through artificial veins.

“He goes into one room, practices deploying the graft, and then goes across the hall and does it on the actual patient,” Thielen said.

Another benefit of the printing lab is the ability for surgeons to physically hold the organs in their hands, according to Thielen. Tactile engagement can teach interventionists a great deal about the best way to approach a tumor resection, for example.

However, the importance of locating the printing lab within the radiology department cannot be overstated, Thielen explained. The printers can cost more than $500,000 each, in addition to the costs of valuable lab space within a crowded hospital and the salaries of radiologists, biomedical engineers, technologists and project managers. The hefty price tag demands an efficient workflow—a workflow that already exists in radiology.

“It’s an extension of what we do with our 3D imaging lab, but we’re displaying our radiology data in a different medium,” Thielen said. “We know data better than anyone else, we can acquire it optimally and display it for collaborating physicians.”

Additional benefits are incurred with centralization. When you have a dedicated team working and learning together, it can lead to more rapid innovation and translation of 3D models to clinical usage.

“If you’ve got an orthopedic model, you can apply some of those tricks and techniques for a heart model,” Thielen said. “If you’ve got several printers running round the clock and maintained correctly, it will be better for the organization than scattering the printers across a few different departments.”

Engagement with other specialties has also seen a drastic increase, building cross-departmental relationships that can spur research or clinical improvement down the road.

“I get comments walking down the hall about what a great benefit this 3D model is, that it allowed them to do a surgical case that they wouldn’t have otherwise been able to do,” Thielen said. “They see radiology as value added, they are enthused about it when they say it.”

Thielen will talk during the session called, “3D Printing: Clinical Applications.” Other presenters’ topics include the roles of 3D printing in congenital heart disease and maxillofacial/orthopedic surgery.